Early Alzheimer’s Disease Diagnosis and Blood Biomarkers: Primary Care Physician Attitudes, Perceptions, and Barriers in the USA
Susan Alford1, Sheena K. Aurora2, Justine Coppinger2, Marti Jimenez-Mausbach3, Rosemary D. Laird4, Hemant Pandey5, Sutapa Ray2, Jeffrey M. Burns6
1Novo Nordisk, Inc., 2C2N Diagnostics LLC, 3Novo Nordisk A/S, 4NAN Navigator Inc., 5Brain and Spine Center, 6University of Kansas Alzheimer's Disease Research Center
Objective:

To uncover primary care physicians’ (PCPs') attitudes on, perceptions of and barriers to Alzheimer's disease (AD) diagnosis and incorporating blood biomarkers (BBMs) into the diagnostic workflow.

Background:

Early and accurate diagnosis of AD is critical for access to targeted lifestyle recommendations and disease-modifying therapies. Historically, diagnosis has been slow, complex, costly and inaccurate. Today, AD diagnosis is evolving from symptom-based exclusion to biomarker-based inclusion, with PCPs expected to play an increasingly important role. Novel assays employing BBMs could support an early and accurate AD diagnosis and be more accessible in primary care than traditional diagnostic tools.

Design/Methods:

Remote 60-minute in-depth interviews with 20 PCPs were conducted (May 12-26, 2023) by 2055 Insights & Strategies, Inc. Participants included generalists and geriatricians representing urban, suburban and rural US practices. Interviews focused on early AD diagnosis, PCP role and referral, BBMs, and key barriers or requirements for their clinical implementation.

Results:

Most PCPs believed that investigating cognitive decline was an important part of their role and were somewhat confident in diagnosing AD but would like to improve their skills. PCPs reported facing barriers such as: complexity and time-consuming nature of current diagnostic methods; lack of effective treatments; and AD diagnosis stigma. PCPs responded positively to BBMs, viewing them as accurate and cost-effective tools that could integrate easily into their practice. However, they expressed concerns about BBM reimbursement and the need for clarity on their place in the diagnostic pathway.

Conclusions:

This study highlights PCPs' interest in supporting AD diagnosis and their receptivity towards integrating BBMs into clinical practice. However, clarity on healthcare coverage and use context is needed before adoption. Continued medical education on diagnosing AD, alongside interpretation and communication of BBM test results, will be beneficial for PCP involvement in AD diagnosis.

Previously presented at AAIC25 and published in Alzheimer's&Dementia (Alford et al. 2025;DOI:TBC ). 

10.1212/WNL.0000000000216167
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.